Objective:

To describe the 36-month clinical course of a patient with severe bilateral ocular injury from sodium amide.

Approach:

• Case: Investigators followed a 23-year-old man after sodium amide and glass fragments injured both eyes, documenting epithelial healing, pannus, other complications, and visual acuity.
• Literature search: The authors searched PubMed, Embase, and chemistry databases for prior reports of sodium amide ocular injury; their English-language search found no specific cases.

Key Findings:

• Both eyes had extensive limbal ischemia, epithelial defects, and corneal opacification. Healing took about 2 months in the left eye and an estimated 90–143 days in the right.
• Fibrovascular pannus began invading both corneas at 2.75 months and recurred or progressed despite medical treatment and repeated surgical resections.
• At 36 months, the left eye achieved 20/25 vision with refraction; right-eye uncorrected acuity ranged from 20/100 to 20/300 during months 30–36.
• Complications included scleral and peripheral corneal thinning and recurrent symblepharon.

Interpretation:

This case documents prolonged epithelial healing and recurrent fibrovascular pannus after severe bilateral sodium amide exposure. At 36 months, the left eye achieved 20/25 vision with refraction, while right-eye uncorrected acuity ranged from 20/100 to 20/300 during months 30–36; healing remained ongoing.

Limitations:

• A single case cannot establish whether these outcomes are typical of sodium amide injuries.
• Multiple treatments were used, so the effect of any individual intervention could not be determined.
• Pannus was diagnosed clinically without histopathologic or immunohistochemical confirmation; quantitative measures of corneal changes and inflammation were unavailable.
• The ultimate outcome was uncertain because healing continued at 3 years.
• English-language search terms may have missed relevant reports.

Conclusion:

The authors described prolonged healing and recurrent fibrovascular pannus after severe bilateral sodium amide exposure. At 3 years, pannus remained, with better visual acuity in the left eye than in the right, and the ultimate outcome was uncertain because healing was ongoing.

Sources:

• Case Reports in Ophthalmological Medicine